Developmental Disabilities Nursing

[luv nursing 40]

i work for a ddso that has approx 130 group homes. direct care aides pass all of the medications. in nys there is a bill being considered to repeal the exempt clause that allows this to happen. we will then need to hire about 720 nurses to cover 24hrs/day in each group home to pass meds. although i agree that only licensed personnel should be doing this it will be extremely difficult to hire all those nurses with the nursing shortage. i was wondering what happens at other omrdd/ddso group homes. i also would like your opinion on repealing the exempt clause.

your living is determined not so much by what life brings to you...as by the attitude you bring to life.

john homer mills

[chwcjw]

Hi , congrats on choosing one of the best fields. First off rules are different in each state. Iam only familiar with NY(30y) and Fl(2y). There are online courses for abnormal psych and DD Nurses, also a VERY expensive certification and questional exam- I did adult population, exam was child and ritalin oriented.

AMAP training is approved by State Nursing Board so contact them for information. Another source would be the largest not for profit dealing with DD population and ask them.

I came down to Fl to State agency APD(adilt persons with disabilities) their DD facility, to imput and provide training. Turned out they had picked some program from OR that provided minimal training and even then the state disapproved it so wound up on floor carrying more degrees than the director.

Still, its one of the most fulfilling areas of nursing. Glad to know you Christopher

[aussiemom]

I worked as an aide in a voluntary IRA in NY state. We passed meds to our consumers under license of a RN. During our initial training, we were given meds admin training- but only for po meds. One of my consumers had diabetes but tested his own glucose and administered his own insulin injections, until he got his pump. When he got his pump, staff were provided a very good in-service on pump management. Our RN visited the IRA regularly to check over the MARs. The most frequent med error committed was not documenting meds that were given, though some pretty significant errors were also committed. One day, I found somebody's meds, poured neatly in a cup, on top of the refrigerator!!

There are definitely advantages to having licensed individuals pass meds (though most of the time aides do a reasonable job), but is NYS really going to pay that many RNs to work at IRAs? Or, will they pay RNs the pitiful wages that aides make? This is not as much of an issue at the state level, where support staff make a relatively living wage, but voluntaries would go out of business in a heartbeat. They pay their support staff less than cooks at IHOP!! Voluntaries are required to follow state regs and provide most of the care to MR/DD folks in NYS. Most of them would fold if this legislation was enacted, and this would be a true shame.

[beckster_01, BSN, RN]

I am a senior in nursing school and have also worked in a group home for almost 4 years in NYS. I became med certified a year before I took any pharmacology/clinical courses in school and I felt that it was sufficient for a group home setting. I believe NY requires the training to be at least 32-40 hours and is pretty extensive. Honestly passing meds in a group home is so much easier than in a hospital. Each individual has a basket with blister packs of medications. You have to initial the blister pack when you punch the med, initial the MAR, and have another staff do a med check with you within an hour of the med pass (they read the MAR and look at the blister pack with you to make sure you delivered the right dose/time/etc.). You have to take a test and do a med pass with the nurse once a year as well. This does not even include the extra training required for staff who care for people with diabetes or G-tubes.

I honestly do not see any problem with non-licensed staff with proper training delivering medications. The hardest part of being med certified is There are numerous checks and balances involved and for homes with 6-8 people it is completely unrealistic to have 24 hour nursing care at each home. Group homes have had so many budget cuts in the last several years that I cannot imagine what would happen if they were forced to hire that many nurses. Of course I cannot speak for institutions that have wider staff-patient ratios, but where I work med errors occur few and far between and usually involve delivering the medication late.